Remove 2000 Remove Shock Remove Stroke
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Glasgow Coma Scale in Children

Pediatric EM Morsels

Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma. Fun fact for animal lovers!- cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! 2008 Apr;39(4):1347-8. doi: 10.1161/STROKEAHA.107.498345.

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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1% Liberal: 14.9%

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A Simple Study May Herald a Big Change in Evidence-Based Medicine

Sensible Medicine

For instance, in the FOURIER trial, the super-expensive PCSCK9 inhibitor, evolocumab, reduced a primary composite outcome (CV death, MI, Stroke, unstable angina, coronary revascularization) vs placebo. We call this acute ischemic stroke or AIS. We are shocked at the response this newsletter has achieved. A brief word of thanks.

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Issue #2: The Latest in Critical Care, 5/22/23

PulmCCM

More patients (9% vs 4%) had adverse events in the early mobilization group, including 7 serious events in the early-mobilization group (mostly arrhythmias and one stroke) vs 1 in the usual care group. At least one expert questioned whether the study was adequately powered. In an NHLBI-sponsored trial enrolling 1563 patients at 60 U.S.

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Grand Rounds Recap 11.29.23

Taming the SRU

Lumbar puncture with xanthochromia or > 2000 RBCs in tube 4 should increase suspicion for SAH. Hemorrhagic shock is the most common etiology of instability in trauma and should always be highest on the differential. Posterior circulation stroke Patients with posterior strokes will likely have a low NIH.

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Is it Time to Take Another Look at the State of Emergency Care in the U.S.? 

ACEP Now

In 2000, as he was completing his second term on ACEP’s Board, he was elected to the IOM – now National Academy of Medicine – in 2000. He then moved to Atlanta, to establish the Emory Center for Injury Control and later served as founding chair of Emory’s Department of Emergency Medicine. National Academics.

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Adventures in RSI

Pediatric Emergency Playbook

Etomidate is perfectly acceptable, but ketamine is actually a superior drug to etomidate in the rapid sequence intubation of children in septic shock. in Anethesia and Analgesia in 2000. On the other side of the spectrum, permissive hypotension is not described in children, as hypotension is a late and dangerous sign of shock.

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